It’s easy to associate rape with the Democratic Republic of Congo, a region torn by conflict since 1996. Dubbed the “rape capital of the world,” the country sees four women raped every five minutes, according to a 2011 study published by the American Journal of Public Health. The consequences of rape—HIV/AIDS, unwanted pregnancy, genital damage, and even rejection by communities—have ripped women and families apart.

But several women in DRC also suffer from a less recognized form of sexualized violence: “survival sex,” the exchange of sexual favors for food or other necessary goods with everyone from NGO workers to UN peacekeepers to local men who have goods that are otherwise scarce. This is not prostitution. It is neither voluntary nor equal.

“Survival sex is one in which women have no choice, where they believe that the only way they are going to make any money, where they’ll be able to keep their job or get a job, is through engaging in sex or in relationships with individuals,” according to Anneke Van Woudenberg, a DRC expert who is featured in “To Serve With Pride,” a video issued in 2006 by the United Nations Task Force for the Protection of Sexual Exploitation and Abuse by UN and Related Personnel. “It is by no means a relationship of equals.”

This kind of violence occurs around the world in warzones and refugee areas in which women are inherently made vulnerable.

Men tasked with providing assistance to refugees from war sometimes end up exploiting them, trading food and other aid for sex. (ISAF Headquarters Public Affairs Office)

On a recent reporting trip to Jordan, a source told WMC’s Women Under Siege that both local and international NGOs were trading sex with Syrian refugees for aid such as food coupons. A July 24 report on Women in the World quotes a Syrian woman in Lebanon named Maryam, 31, as saying: “One of the men at an NGO told her that if you accept to sleep with me, if we can have sexual relations, every time I have any kind of access to assistance, it will be yours. It will have your name on it.”

Holocaust scholars have also documented cases of survival sex in which women in concentration camps were forced to have sex with guards in order to obtain a bit of bread, or even with the so-called “righteous,” who hid Jewish women in their houses or fields to “protect” them.

When the very people meant to help refugees are exploiting them, alarms should be going off at the international level. But even the UN has historically had its share of peacekeepers involved in the sexual exploitation of incredibly vulnerable populations.

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“We were walking home from school when a driver in a UN car pulled over,” a young Congolese girl’s voice says. “The driver told me he loved me. He had pints of milk in the back of his car, which he gave to my friend and me.”

The girl and her friend had sex with the men several times, and both became pregnant. The men eventually abandoned the girls and their families cast them out of their homes. Before long, they were forced to give up school to care for their children.

The story of these girls is told in “To Serve With Pride.” The video documents exploitation and abuse by UN personnel and other humanitarian workers, the people who are supposed to protect vulnerable civilians from sexual abuse and end up becoming the perpetrators of the crimes. [WMC’s Women Under Siege documented more on this subject in our May 2012 report.]

The UN is tasked with the “collective responsibility to uphold the highest standards and protect all those [it] serve[s],” according to former UN Secretary-General Kofi Annan. In 2011, the UN Security Council adopted a resolution calling for the continuation and strengthening of efforts to implement the policy of zero tolerance of sexual exploitation and abuse in UN missions. More than 10 years before that, the UN Security Council adopted another resolution calling for a gender perspective that includes the special needs of women and girls in conflict and post-conflict situations.

But statistics published by the UN’s Office of Internal Oversight Services found that of the 60 allegations of sexual exploitation and abuse reported in 2012 throughout UN missions, almost half had occurred in MONUSCO, the UN mission deployed in the Democratic Republic of the Congo. Those 25 cases had been perpetrated by personnel affiliated with the UN, the report said.

Sexualized violence in the DRC has been extensively documented, but less in the forefront are the abuses committed by humanitarian personnel—those personnel who have been sent to prevent the abuses from happening in the first place. This is yet another form of rape brought on by conflict and dire poverty.

“To Serve With Pride” tells the chilling account of one woman in a camp: “We have needs in the refugee center, and when we have insufficient relief supplies or other facilities to fulfill these needs, if someone tries to tempt us into exchanging something, then we have to agree.”

“Where there is desperation, buying sex is cheap and easy,” says the narrator of the video.

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The reasons these abuses continue are numerous, but three main causes seem to stand out: lack of training, lack of local awareness, and impunity.

Claus Hjorth Madsen, a Danish officer deployed as a UN Blue Helmet in 2010 in South Sudan, told me in May 2013 that prior to his deployment, he took part in cultural awareness classes and gender-sensitive training, which covered sexual exploitation and abuse and included such topics as ways to interact with local women. He was instructed not to socialize with the local population and not to visit sex workers—such behavior, he said they were told, gives the wrong signal to civilians about the role of peacekeepers.

But Madsen said that not all UN national staff receive such training: “It is well known that not all countries have the time, resources, or will to provide gender and cultural training to its personnel.” India and Bangladesh, he said, are among those troop contributors that do not provide the same in-depth training that he received. This disparity between trainings highlights the need for a UN-coordinated mechanism that ensures all personnel are trained in accordance with UN standards.

Experts have also said that local women are not informed of their rights, which leads to “ignorance, illiteracy, poverty, and impunity [as] the main challenges” in stopping sexual exploitation and abuse by humanitarian personnel, according to the director of a local NGO in the DRC who spoke on condition of anonymity. In May 2013, the director, whose organization focuses on human rights and women’s rights, said that local women were not aware of existing complaint mechanisms in the legal framework and therefore didn’t seek justice after being abused.

The UN’s Protection of Sexual Exploitation and Abuse by UN and Related Personnel Task Force also acknowledges the importance of raising awareness among the local population about their rights, including, for example, their entitlement to aid without any requirement for sexual favors.

The NGO director emphasizes that victims should be granted adequate assistance, including awareness of their rights, access to safe abortion clinics, and health advice. He suggests that assistance clinics be created, places where victims can report and get fast responses to cases of sexual exploitation and abuse by humanitarian and UN workers.

The UN must also take steps to ensure that commanding officers are held accountable for their actions or those of their subordinates. In addition, stronger penalties should be enforced for perpetrators of rape. In a report for Refugees International, “Ending Sexual Exploitation & Abuse in UN Peacekeeping Missions,” Sarah Martin says that under current law, perpetrators who are UN personnel are returned to their home countries, with UN instructions to national governments to prosecute. This absence of a mechanism to ensure prosecution leaves victims with no support or reparation measures.

Unfortunately, many NGOs have no such public or institutional oversight in these cases. And women stuck in the limbo of war and survival will continue to do what they need to in order to feed their children and themselves. As long as no better options exist, women will remain vulnerable in warzones and refugee areas.